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Long Term Care Counselling Checklist
Patient Name:(Last Name, First Name)Health Card No. Version Contour signature or a signature from your Power of attorney (POA) or Substitute decision maker (SDM)
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How to fill out substitute decision makers and

How to fill out substitute decision makers and
01
Determine who will be the substitute decision maker for the individual.
02
Complete the necessary paperwork or documentation provided by the relevant authorities.
03
Ensure that the substitute decision maker understands their role and responsibilities.
04
Keep a copy of the paperwork on file for easy reference when needed.
Who needs substitute decision makers and?
01
Individuals who are unable to make decisions for themselves due to mental incapacity or disability.
02
Patients who are unconscious or otherwise unable to communicate their wishes.
03
Elderly individuals who may need assistance with decision making.
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What is substitute decision makers and?
Substitute decision makers are individuals appointed to make decisions on behalf of someone who is unable to make decisions for themselves.
Who is required to file substitute decision makers and?
Substitute decision makers are typically appointed by a court or designated through a legal document such as a power of attorney.
How to fill out substitute decision makers and?
To fill out substitute decision makers, you will need to provide information about the appointed individual's name, contact information, relationship to the person they are making decisions for, and any relevant legal documents.
What is the purpose of substitute decision makers and?
The purpose of substitute decision makers is to ensure that someone who is unable to make decisions for themselves has someone legally appointed to act on their behalf.
What information must be reported on substitute decision makers and?
The information that must be reported on substitute decision makers includes the appointed individual's name, contact information, relationship to the person they are making decisions for, and any relevant legal documents.
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